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https://www.readbyqxmd.com/read/29775994/a-broader-understanding-of-care-managers-attitudes-of-advance-care-planning-a-concurrent-nested-design
#1
Julie Aultman, Kristin R Baughman, Ruth Ludwick
AIMS AND OBJECTIVES: To examine barriers of advance care planning (ACP) experienced by care managers (CMs) through a mixed methods approach. A concurrent nested design was used to acquire a deeper understanding of ACP, and to identify nuances between quantitative and qualitative data. BACKGROUND: Past quantitative studies on providers have identified barriers related to time, culture, knowledge, responsibility, and availability of legal documents. These barriers, and accompanying attitudes and feelings, have been taken at face value without rich qualitative data to identify under what conditions and to what extent a barrier impacts care...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29771223/enabling-physicians-to-lead-canada-s-leads-framework
#2
Graham Dickson, John Van Aerde
Purpose The purpose of this paper is to provide a case study demonstrating that LEADS in a Caring Environment Capabilities Framework in Canada can assist physicians to be partners in leading health reform. Design/methodology/approach A descriptive case-based approach was followed, relying on existing documents, research papers and peer-reviewed articles, to substantiate the effect of LEADS on physician leadership in Canada. Findings The Canadian LEADS framework enables physicians to lead by providing them with access to best practices of leadership, acting as an antidote to fragmented leadership practice, setting standards for development and accountability and providing opportunities for efficient and effective system-wide leadership development and change...
May 8, 2018: Leadership in Health Services
https://www.readbyqxmd.com/read/29768064/a-look-at-treatment-strategies-for-relapsed-multiple-myeloma
#3
Giusy Cetani, Mario Boccadoro, Stefania Oliva
Multiple myeloma treatment considerably improved during the past decade, thanks to novel effective drugs, a better understanding of myeloma biology and clonal heterogeneity, and an improved management of toxicities. The choice of regimen at relapse is usually based on prior response, toxicities, age and comorbidities of relapsed patients. Areas covered: A review was performed of the most recent and effective therapeutic strategies for the relapsed myeloma setting, by documenting the latest clinical evidence from phase II and III clinical trials...
May 16, 2018: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/29767834/nutrition-care-of-cancer-patients-a-survey-among-physicians-and-nurses
#4
N Erickson, K Paradies, D Buchholz, J Huebner
In order to quantify gaps in the provision of medical nutrition care in Germany and pinpoint specific areas of need, we collected data from patients, nurses and physicians. The results from the patient survey were published separately. A total of 506 participants from 69 certified centers answered the questions developed in cooperation with representatives from different professional groups (physicians, nurses and dietitians). Only about a third of participants reported that their institution provides structured pathways to nutritional counseling...
May 16, 2018: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29766520/the-role-of-electronic-health-records-in-clinical-reasoning
#5
REVIEW
Markus Berndt, Martin R Fischer
Electronic health records (eHRs) play an increasingly important role in documentation and exchange of information in multi-and interdisciplinary patient care. Although eHRs are associated with mixed evidence in terms of effectiveness, they are undeniably the health record form of the future. This poses several learning opportunities and challenges for medical education. This review aims to connect the concept of eHRs to key competencies of physicians and elaborates current learning science perspectives on diagnostic and clinical reasoning based on a theoretical framework of scientific reasoning and argumentation...
May 16, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29765441/suspected-unexpected-and-other-adverse-reactions-to-antiretroviral-drugs-used-as-post-exposure-prophylaxis-of-hiv-infection-five-year-experience-from-clinical-practice
#6
Justyna D Kowalska, Ewa Pietraszkiewicz, Ewa Firląg-Burkacka, Andrzej Horban
Introduction: With increased use of antiretroviral drugs (ARVs) in HIV uninfected persons, proper reporting on suspected unexpected serious adverse reactions (SUSARs) and continued insight into adverse drug reactions (ADRs) are needed for adequate information on safety of ARVs in such populations. Material and methods: Medical documentation of persons receiving ARVs after non-occupational HIV exposure (non-occupational post-exposure prophylaxis - nPEP) during 5 successive years (2009-2013) was evaluated by two HIV physicians...
April 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29761024/relationships-between-activity-and-well-being-in-people-with-parkinson-s-disease
#7
Felicitas Ehlen, Katharina Schindlbeck, Lisa Nobis, André Maier, Fabian Klostermann
Objectives: The complex symptomatology of Parkinson' disease (PD) usually goes along with reduced physical activity. Previous studies have indicated positive effects of activating therapies on patients' well-being. This study, therefore, examined how activity in daily life is related to patients' subjective condition. Materials and Methods: Twenty-one PD patients rated their condition every two hours during two routine days and documented the duration and type of their activities (based on the PRISCUS-Physical Activity Questionnaire) during the respective time intervals...
May 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29759724/diagnostic-value-of-mri-in-patients-with-implanted-pacemakers-and-implantable-cardioverter-defibrillators-across-a-cross-population-does-the-benefit-justify-the-risk-a-proof-of-concept-study
#8
Huma Samar, June A Yamrozik, Ronald B Williams, Mark Doyle, Moneal Shah, Christopher A Bonnet, Robert W W Biederman
OBJECTIVES: The objective of this study was to assess the diagnostic usefulness of thoracic and nonthoracic magnetic resonance imaging (MRI) imaging in patients with implantable cardiac devices (permanent pacemaker or implantable cardioverter-defibrillators [ICDs]) to determine if there was a substantial benefit to patients with regard to diagnosis and/or management. BACKGROUND: MRI is infrequently performed on patients with conventional pacemakers or ICDs. Multiple studies have documented the safety of MRI scans in patients with implanted devices, yet the diagnostic value of this approach has not been established...
September 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759656/well-being-among-emergency-medicine-resident-physicians-results-from-the-abem-longitudinal-study-of-emergency-medicine-residents
#9
Debra G Perina, Catherine A Marco, Rebecca Smith-Coggins, Terry Kowalenko, Mary M Johnston, Anne Harvey
BACKGROUND: The Longitudinal Study of Emergency Medicine Residents (LSEMR) conducted by the American Board of Emergency Medicine queries a randomized cohort of emergency medicine (EM) residents. It is designed to identify residents' perceptions of their training, sources of stress, well-being level, and career choice satisfaction over time. OBJECTIVES: This study utilizes LSEMR to identify resident well-being levels, career satisfaction, factors producing stress, and whether a specific cohort is more stressed than the overall respondent group...
May 11, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29759501/assessment-of-atrial-fibrillation-specific-symptoms-before-and-2-years-after-atrial-fibrillation-ablation-do-patients-and-physicians-differ-in-their-perception-of-symptom-relief
#10
Anna Björkenheim, Axel Brandes, Anders Magnuson, Alexander Chemnitz, Lena Svedberg, Nils Edvardsson, Dritan Poçi
OBJECTIVES: The aim of this study was to evaluate patient-reported and physician-assessed atrial fibrillation (AF)-related symptoms after AF ablation. BACKGROUND: Success of AF ablation is usually defined as freedom from AF, although symptom relief is often patients' desire. METHODS: Symptom relief was assessed as perceived by patients using the short, validated, AF-specific symptom questionnaire AF6 and as classified by physicians using the European Heart Rhythm Association (EHRA) classification at baseline and 6, 12, and 24 months after AF ablation...
October 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759422/executive-summary-of-the-gesida-national-aids-plan-consensus-document-on-antiretroviral-therapy-in-adults-infected-by-the-human-immunodeficiency-virus-updated-january-2018
#11
(no author information available yet)
This update to the document on antiretroviral therapy (ART) in adults, which has been prepared jointly by GeSIDA and the Spanish National AIDS Plan for the last two decades, supersedes the document published in 2017.1 The update provides physicians treating HIV-1-infected adults with evidence-based recommendations to guide their therapeutic decisions. The main difference with respect to the previous document concerns recommended initial ART regimens, only three of which are maintained as preferential. All three include dolutegravir or raltegravir, together with emtricitabine/tenofovir alafenamide or abacavir/lamivudine...
May 11, 2018: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29759257/developing-a-medical-scribe-program-at-an-academic-hospital-the-hennepin-county-medical-center-experience
#12
Marc L Martel, Brian H Imdieke, Kayla M Holm, Sara Poplau, William G Heegaard, Jon L Pryor, Mark Linzer
BACKGROUND: Medical scribes are frequently incorporated into the patient care model to improve provider efficiency and enable providers to refocus their attention to the patient rather than the electronic health record (EHR). The medical scribe program was based on four pillars (objectives): (1) provider satisfaction, (2) standardized documentation, (3) documentation components for risk adjustment, and (4) revenue enhancement. METHODS: The medical scribe program was deployed in nine non-resident-supported clinics (internal medicine, ophthalmology, orthopedics, hematology/oncology, urology), with the medical scribes (who have no clinical duties) supporting both physicians and advanced practice providers (nurse practitioners and physician assistants)...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29757917/nurse-practitioners-completion-of-physician-orders-for-scope-of-treatment-forms-in-west-virginia-a-secondary-analysis-of-12-months-of-data-from-the-state-registry
#13
Lori Anne Constantine, Toni Dichiacchio, Evan C Falkenstine, Alvin H Moss
BACKGROUND AND PURPOSE: Advanced care planning documents, such as the Physician Orders for Life-Sustaining Treatment (POLST), require authorized medical provider signatures; only recently have nurse practitioners (NPs) been authorized to sign these forms. Recent legislation in West Virginia (WV) granting NPs signatory authority on POLST forms and the creation of a statewide registry provides an opportunity to examine the completion rates. The aim of this study was to investigate how recent legislation allowing NPs signatory authority for POLST forms has affected POLST completion...
January 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29757036/determinants-of-antibiotics-prescribing-among-doctors-in-a-nigerian-urban-tertiary-hospital
#14
Olayinka O Ogunleye, Joseph O Fadare, Adesola F Yinka-Ogunleye, Bene D Anand Paramadhas, Brian Godman
BACKGROUND AND OBJECTIVE: The problem of antimicrobial resistance (AMR) has assumed pandemic dimensions especially among low and middle-income countries such as Nigeria. Irrational use of currently available antimicrobial agents is a major contributory factor. There remains a paucity of documented information on the determinants of antibiotics prescribing among physicians in Nigeria to guide future strategies to reduce AMR. This study therefore aimed to investigate the patterns and determinants of antibiotics prescription among doctors in a tertiary hospital in Nigeria as the first step to improve future antibiotic use in hospitals...
May 14, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29756475/national-survey-of-pediatric-care-providers-assessing-time-and-impact-of-coding-and-documentation-in-physician-practice
#15
Anshul Arora, Ashish Garg, Vrinda Arora, Munaza Rizvi, Ninad Desai
BACKGROUND: Documentation and billing/coding are essential to medical practice. Physicians spend significant time documenting to meet coding and medicolegal requirements, potentially reducing time for patient care and learning. We sought to assess time spent charting in pediatric practice and provider understanding and comfort level regarding billing/coding. METHODS: An anonymous web-based survey was emailed to members of American Academy of Pediatrics Section of Pediatric Trainees practicing in the United States...
May 1, 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/29755917/sharing-is-caring-minimizing-the-disruption-with-palliative-care
#16
EDITORIAL
Abd Moain Abu Dabrh, Robert P Shannon, Richard J Presutti
There is an upward trend incidence of multiple chronic life-limiting conditions with a well-documented associated impact on patients and their caregivers. When patients approach the end of life, they are often faced with a challenging multidimensional burden while navigating a complex health care system. Patients and families/caregivers are faced with daily decisions, often with little or no frame of reference or medical knowledge. The "what, how, when, and where" puzzle during this challenging time can be overwhelming for patients and their families, and when clinicians do not contemplate this associated workload's impact on patients and caregivers' capacity for self-care, patients and caregivers scramble to find compensatory solutions, often putting their health care at lower priority...
March 13, 2018: Curēus
https://www.readbyqxmd.com/read/29752897/ajo-centennial-the-influence-of-early-ophthalmic-hospitals-on-the-journal
#17
Akhilesh S Pathipati, James C Tsai
PURPOSE: To consider the American Journal of Ophthalmology's role as not only a forum to describe clinical and scientific advances but also as a record of institutional histories. We used the New York Eye and Ear Infirmary of Mount Sinai, the Massachusetts Eye and Ear Infirmary, and the Wills Eye Hospital as case studies on the journal's role in documenting the people and organizations that have moved ophthalmology forward. DESIGN: Perspective METHODS: Using the ScienceDirect database, we conducted a literature search to gather all mentions of the three eye hospitals in the journal's archives from 1918 to 2018...
May 9, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29752581/differences-in-physician-income-by-gender-in-a-multiregion-survey
#18
Eric A Apaydin, Peggy G C Chen, Mark W Friedberg
BACKGROUND: Previous studies have documented income differences between male and female physicians. However, the implications of these differences are unclear, since previous studies have lacked detailed data on the quantity and composition of work hours. We sought to identify the sources of these income differences using data from a novel survey of physician work and income. OBJECTIVE: To compare differences in income between male and female physicians. DESIGN: We estimated unadjusted income differences between male and female physicians...
May 11, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29750933/regional-thoracic-surgery-quality-collaboration-formation-providence-thoracic-surgery-initiative
#19
John R Handy, Kimberly Costas, Robert McKenna, Steven Nisco, Raymond Schaerf, Kenton Stephens, Eric Vallières, Kasia Konieczny, Roshanthi Weerasinghe, Mansen Wang, Katherine Lothrop, Cathy Betzer
BACKGROUND: Surgery quality initiatives improve clinical outcomes in cardiac and general surgery. No mature thoracic surgery (TS) regional effort has been described. METHODS: An intramural grant funded the Thoracic Surgery Initiative (TSI). Using professional organization, site specific administrative and clinical databases, surgeons performing TS across a large western health system were identified. Participants were recruited through stakeholder surveys, personal contact and meetings...
May 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29747695/a-case-report-of-granulomatous-amoebic-encephalitis-by-group-1-acanthamoeba-genotype-t18-diagnosed-by-the-combination-of-morphological-examination-and-genetic-analysis
#20
Takahiro Matsui, Tetsuo Maeda, Shinsuke Kusakabe, Hideyuki Arita, Kenji Yagita, Eiichi Morii, Yuzuru Kanakura
BACKGROUND: The diagnosis of granulomatous amoebic encephalitis is challenging for clinicians because it is a rare and lethal disease. Previous reports have indicated that Acanthamoeba with some specific genotypes tend to cause the majority of human infections. We report a case of granulomatous amoebic encephalitis caused by Acanthamoeba spp. with genotype T18 in an immunodeficient patient in Japan after allogenic bone marrow transplantation, along with the morphological characteristics and genetic analysis...
May 10, 2018: Diagnostic Pathology
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